An aim of modern medicine is to provide personalized or individualized treatment regimens. Those are treatment regimens which take into account a patient's individual needs or risks. A particularly important risk is the presence of cardiovascular complication, especially of an acute cardiovascular event. Cardiovascular complications belong to the leading causes of morbidity and mortality in the Western hemisphere. For individual treatment of a person who suffers from a cardiovascular complication, a reliable diagnosis has a significant impact on the success of the treatment of said person. This is particularly important for patients showing signs and symptoms of acute coronary syndrome (ACS).
Clinical symptoms of acute coronary syndrome are believed to be caused by acute myocardial ischemia. Patients with chest pain or signs and symptoms of instable angina or acute coronary syndrome (ACS) frequently present to their doctor as an emergency or to the emergency room. Clinical evaluation of these patients includes a medical history specifically directed to evidence of existing cardiovascular disease or their risk factors, analysis of the type of symptoms as described as well as clinical signs associated with acute coronary syndrome such as evidence of pulmonary edema, hypotension and/or Tachy- or bradycardia. Additionally, clinical evaluation often includes performing an electrocardiogram (ECG) and possibly laboratory tests on these patients.
Although acute chest pain is the leading symptom of ACS, it is not specific for cardiovascular disease or ACS. Symptoms of chest pain may originate from vascular disorders such as pulmonary embolism, aortic dissection or pulmonary hypertension or from pulmonary diseases such as pleuritis, pneumonia, tracheobronchitis and spontaneous pneumothorax. Symptoms of acute chest pain may also originate from gastrointestinal disease such as esophageal reflux, peptic ulcer, gallbladder disease and pancreatitis. Additionally, musculosceletal causes of acute pain may include costochondritis, cervical disc disease, trauma or strain. Herpes zoster may also causes acute chest pain. Even further, panic disorder needs to be considered as differential diagnosis.